Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 1015712 | MA |
NPI | 1003230376 |
---|---|
Provider Name | Carolyn Mcmurry |
First Address | Paxton, MA 01612-1275 |
Second Address | Paxton, MA 01612-1275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2014 |
Last Update Date | 07/02/2014 |